Tubulointerstitial nephritis as adverse effect of programmed cell death 1 inhibitor, nivolumab, showed distinct histological findings.

Immune-checkpoint inhibitor nivolumab (anti-PD-1 antibody) blocks T cell inhibition and stimulate immunologic response toward cancer cells. It was also revealed that PD-1/PD-L1 interaction crucially controls the effector differentiation of auto-reactive T cells to maintain self-tolerance. Therefore, potential autoimmunological side-effect can occur in any organ. Here, we report a case of 67-year-old Japanese male with lung adenocarcinoma treated with nivolumab who developed acute tubulointerstitial nephritis after the third infusion of nivolumab. Kidney biopsy showed distinct histological findings: Proliferation of CD38 positive and IgG positive plasma cells, and affluent infiltration of FoxP3+ regulatory T cells. Herein, we do pathological discussion concerning acute tubulointerstitial nephritis occurred in this case based on these histological findings.

Clopidogrel-induced Thrombotic Microangiopathy in a Patient with Hypocomplementemia.

Clopidogrel was administered to a 67-year-old Japanese man to prevent the recurrence of cerebral infarction. Twelve weeks later, he was admitted to our hospital with acute renal failure, hemolytic anemia and thrombocytopenia, and was diagnosed with clopidogrel-induced thrombotic microangiopathy. Clopidogrel was immediately discontinued and corticosteroid and plasma exchange therapy were administered simultaneously. Thereafter, the patient's condition gradually improved. The patient had a decreased serum complement C3 level. This suggests that the activated alternative pathway is related to thrombotic microangiopathy (TMA). TMA is a critical drug-associated adverse reaction that clinicians should always be vigilant about, because clopidogrel is widely prescribed.

ESR dating of barite in sulphide deposits formed by the sea-floor hydrothermal activities.

Barite is a mineral newly found to be practically useful for electron spin resonance (ESR) dating of sulphide deposits formed by the sea-floor hydrothermal activities. The recent studies for the properties of the ESR dating signal in barite are summarised in the present paper as well as the formulas for corrections for accurate dose-rate estimation are developed including the dose-rate conversion factors, shape correction for gamma-ray dose and decay of (226)Ra. Although development of the techniques for ESR dating of barite has been completed, further comparative studies with other dating techniques such as U-Th and (226)Ra-(210)Pb dating are necessary for the technique to be widely used.

A case report of compensation in daily life of a person with memory problems: detailed functional use of memory aids over a five-year period.

Numerous studies have been conducted on memory aids for memory-impaired people. However, it is not known how they use these memory aids in a functional, practical way. A 20-year-old patient (MH) was monitored for five years to identify what memory aids or other means she used and how she used them to compensate for her memory problems, e.g., forgetting what was said by others in a few minutes and getting lost or turning in the wrong direction on a walk or in a building. Results indicated MH did not necessarily always use memory aids such as a notebook or calendar to compensate for her memory problems, although MH and her mother reported that she frequently used them in daily life. She coped with memory problems by using various "resources" besides the memory aid. These facts suggest that it may be necessary to redefine functionally useful compensations, which include both memory aids and resources in daily life.